Sign-On Statement Against U.S. Drug-Price Increases

The following consensus statement reflects concerns that there might be a new round of major U.S. price increases for AIDS drugs over the next several months -- starting with the new enteric-coated ddI, and the protease inhibitor ABT-378.

If you or your organization can sign, send your endorsement by email to lgrinberg@aol.com, or by fax to 310-471-4565. The 25 organizations and 50 individuals who have currently signed are listed below.

Consensus Statement on the Pricing of Enteric-Coated ddI and ABT-378

We, the undersigned, have serious concerns regarding the growing costs of therapy for HIV disease. While we are heartened by the progress made in moving toward simpler, easier to use regimens, we are dismayed by the possibility that prices of new drugs and price increases of approved drugs are escalating ever higher, and with each new price increase setting new benchmarks. As drugs become available which might facilitate better adherence and possibly more durable long-term treatment, manufacturers should be planning to lower or at least contain the daily cost of their regimens, not increase them. The long-term survival afforded by the present generation of therapies makes it possible for manufacturers to set lower, or at least stable prices, and still have adequate incentive to reinvest in continued development of HIV/AIDS drugs.

Recently cited reductions in the overall cost of health care for HIV-infected people will almost certainly be reversed in coming years if manufacturers continue to increase or maintain current pricing levels. We are in a new era in the treatment of HIV disease and rethinking drug pricing which reflects this changing reality is long overdue.

To the best of our knowledge, the development costs of Bristol Myers Squibb new enteric-coated formulation of ddI and Abbott Labs' new protease inhibitor, Aluviran(TM) (lopinavir), do not justify a leap in prices. There has been nothing extraordinary about the cost of clinical trials required to bring these new formulations and drugs to market, while the duration of their use by patients may be greatly extended.

Enteric-coated ddI is likely to be used by both treatment-naive and treatment-experienced patient populations, making its potential market very large. The tolerability profile of the earlier versions of this drug has long suppressed its sales, resulting in pent-up demand for an effective nucleoside analogue drug. If the price is as high as current indications suggest, and the drug is used in naive populations in place of existing drugs, the overall cost of therapy will go up substantially. Similarly, if the price of lopinavir reaches new heights for a protease inhibitor and it is used by both treatment-naive and treatment-experienced people, the overall cost of therapy will escalate dramatically. We cannot stand idly by while the price of living with HIV disease rises so rapidly. ADAP programs and other forms of government funding support have limited amounts of money allocated to them each year. Moreover, the long-term use of extremely expensive drugs is threatening the lifetime limits of many private insurance policies.

Some state ADAP and Medicaid programs have removed vital medications to prevent and treat opportunistic infections from their formularies. State ADAP and Medicaid programs are under close scrutiny by governmental panels in order to cut costs. The price of one drug can affect the availability of other medications. Increasingly, this same sad scenario is beginning to affect the availability of drugs within HMO settings. The price of these drugs will have a pervasive impact on the overall quality of care people with HIV/AIDS receive in this country.

Bristol Myers Squibb and Abbott Labs have expressed a strong desire to create goodwill and cooperative working relationships with the community. No one wants to see those relationships jeopardized over this issue, but that surely will occur if pricing is inappropriate. Exploitative pricing will trigger widespread mistrust, contentious debate, and closer scrutiny of industry practices in general and give comfort to those who think that AIDS is simply a scam designed to line the coffers of the pharmaceutical industry. This will have far-reaching consequences.

Though we call for a major reduction in the price of HIV therapies in general, these drugs must at least be priced fairly and in accordance with other drugs of their respective classes. Neither represents a major advance in therapy that might otherwise reduce the overall cost of care. We urge manufacturers to rethink their plans for pricing and to act as responsible citizens playing a key role in the fight against a worldwide epidemic. Without responsible pricing, there can be no constructive dialogue between industry and the HIV affected populations worldwide.

Organizations which have signed as of April 20:

1. ACT UP/East Bay, Oakland, CA

2. Agua Buena Human Rights Association, Costa Rica

3. AIDS Action Baltimore, Baltimore, MD

4. AIDS Survival Project, Atlanta, GA

5. AIDS Treatment & Data Network, New York, NY

6. Asian & Pacific Islander Wellness Center: Community HIV Services, San Francisco, CA

7. Canadian Treatment Advocates Council, Toronto, ON CANADA

8. Community Prescription Service, New York, NY

9. DAAIR, New York, NY

10. FLAAC/Florida AIDS Action Council, Miami, Florida

11. Foundation for AIDS and Immune Research, Los Angeles, CA

12. Hepatitis C Action & Advocacy Coalition (HAAC), New York, NY

13. Hepatitis C Action & Advocacy Coalition (HAAC), San Francisco, CA

14. HIVCare at St. Francis Memorial Hospital, San Francisco, CA

15. Project Inform, San Francisco, CA

16. Lighthouse Group, Asheville, NC

17. Nashville CARES, Nashville TN

18. NATAP (National AIDS Treatment Advocacy Project) New York, NY

19. N. Carolina AIDS Policy Center, Asheville, NC

20. PWA Health Group, New York, NY

21. San Francisco AIDS Foundation, San Francisco, CA

22. Search for a Cure, Boston, MA

23. Sisters of St. Elizabeth of Hungary, San Juan Capistrano, CA

24. Survive AIDS (formerly ACT UP Golden Gate), Francisco, CA

25. Treatment Action Group, New York, NY

Also, 49 individuals signed by April 20.

ISSN # 1052-4207

Copyright 2000 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.

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